18:58 PM

Horizon Announces Initial Steps to Support Members Through COVID-19 Outbreak

Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) members will have access to a wide array of supports from the state’s leading health insurer as New Jersey prepares to deal with the impact of the growing COVID-19 outbreak.

“The health and well-being of our members is our top priority. These steps will help them access the care they need with coverage that reflects the unique situation created by COVID-19,” said Kevin P. Conlin, Chairman, President and CEO of Horizon BCBSNJ. “We’re working closely with our customers, the state’s public health leadership, and our provider partners across New Jersey to prepare and these first steps reflect our readiness to adapt to the situation as it evolves. In addition to the changes we are making for our insured members, Horizon will continue to work with our self-insured customers on their specific plan designs Our members and customers can rest assured that Horizon is responding to this emerging public health threat.”

Effective Immediately, Horizon BCBSNJ is taking these steps:

  • Waiver of Prior Authorization for diagnosis of COVID-19
    • Waiving prior authorizations for a visit to a primary care physician, urgent care center, or emergency room for evaluation of upper respiratory symptoms, fever, shortness of breath or other conditions that may represent COVID-19.
    • Waiving prior authorizations for diagnostic tests and for covered services that are medically necessary and consistent with CDC guidance if diagnosed with COVID-19.
    • Waiving prior authorization for lab studies or diagnostic testing required during an ER evaluation or inpatient hospital stay.
  • Horizon will cover the full cost of the COVID-19 test
    • We will cover, with no cost share to the member, the appropriate medically necessary diagnostic testing for COVID-19.
  • Increased access to prescription medications
    • Waive early medication refill limits on 30-day prescription maintenance medications (consistent with member’s benefit plan) and/or encourage members to use 90-day mail order benefit. Horizon will also ensure formulary flexibility if there are shortages or access issues and not hold patients liable for additional charges stemming from obtaining a non-preferred medication resulting from shortages or access issues.
  •  Access to Telehealth and Nurse Advice Hotlines
    • Horizon members will have no cost, 24/7 access to licensed nurses who can assess and assist members with symptoms that are consistent with suspected COVID-19 infection. Those service are available through the company’s free “Horizon Blue” app, the www.HorizonBlue.com online portal, or by phone at 1-888-624-3096. Members may also use those services to consult with a nurse about other health concerns and potentially avoid a visit to a physician office or urgent care facility.